Filing Number: 808838
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| Filing Accepted: 2/27/2025 |
| Last/Business Name
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HERNANDEZ ASEN
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First Name |
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SADAY |
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| Street Address
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8711 NORTH PAWNEE AVENUE |
| City, State Zip
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TAMPA,
FL
33617
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| Email Address
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SADAY0219@GMAIL.COM |
| Complainant Type:
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Insured |
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| Last/Business Name* |
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HERNANDEZ ASEN |
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First Name |
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SADAY |
| Policy # * |
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SIC3063401 |
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Claim #* |
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202409005402 |
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Attorney is Applicable
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| Last Name* |
MELAMED
First Name *
AARON
Initial
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| Street Address* |
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20200 WEST DIXIE HIGHWAY, SUITE 902 |
| City, State Zip* |
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AVENTURA
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FLORIDA
33180
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| Email Address * |
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AARON@MELAMEDLAWPLLC.COM |
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| Insurer Type
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Authorized Insurer
Unauthorized Insurer
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| Insurer Name |
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| Insurer Name* |
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SLIDE INSURANCE COMPANY
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| Insurer Name* |
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| Street Address* |
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| City, State Zip* |
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,
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NAIC Company Code 17227 |
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| Name of individual responsible for violation (if any):*
SONYA HARRIS, DONALD DAVIS, DELYNSI CHE, AND ALL OTHER ADJUSTERS, SUPERVISORS, MANAGEMENT, AND INDIVIDUALS ASSOCIATED WITH OR RETAINED BY SLIDE INSURANCE COMPANY INVOLVED IN THIS CLAIM.
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| Type of Insurance
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Residential Property & Casualty
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| Reason for Notice
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Claim Delay
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Unsatisfactory Settlement Offer
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Unfair Trade Practice
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Statutory provision(s) which the insurer allegedly violated.
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| 624.155(1)(b)(1) |
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Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
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| 624.155(1)(b)(3) |
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Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
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| 626.9541(1)(i)(3)(a) |
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Failing to adopt and implement standards for the proper investigation of claims.
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| 626.9541(1)(i)(3)(c) |
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Failing to acknowledge and act promptly upon communications with respect to claims.
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| 626.9541(1)(i)(3)(h) |
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Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
SECTION I – PERILS INSURED AGAINST A. Coverage A – Dwelling And Coverage B – Other Structures 1. We insure against risk of direct physical loss to property described in Coverages A and B.
SECTION I – PROPERTY COVERAGES A. Coverage A – Dwelling 1. We cover: a. The dwelling on the "residence premises" shown in the Declarations, including structures attached to the dwelling; and b. Materials and supplies located on or next to the "residence premises" used to construct, alter or repair the dwelling or other structures on the "residence premises".
C. Loss Settlement In this Condition C., the terms "cost to repair or replace" and "replacement cost" do not include the increased costs incurred to comply with the enforcement of any ordinance or law, except to the extent that coverage for these increased costs is provided in E.11. Ordinance Or Law under Section I – Property Coverages. Covered property losses are settled as follows: 1. Property of the following types: a. Personal property; b. Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings; c. Structures that are not buildings; and d. Grave markers, including mausoleums; at actual cash value at the time of loss but not more than the amount required to repair or replace. 2. Buildings covered under Coverage A or B at replacement cost without deduction for depreciation, subject to the following: a. If, at the time of loss, the amount of insurance in this policy on the damaged building is 80% or more of the full replacement cost of the building immediately before the loss, we will pay the cost to repair or replace, after application of any deductible and without deduction for depreciation, but not more than the least of the following amounts: (1) The limit of liability under this policy that applies to the building; (2) The replacement cost of that part of the building damaged with material of like kind and quality and for like use; or (3) The necessary amount actually spent to repair or replace the damaged building.If the building is rebuilt at a new premises, the cost described in (2) above is limited to the cost which would have been incurred if the building had been built at the original premises. b. If, at the time of loss, the amount of insurance in this policy on the damaged building is less than 80% of the full replacement cost of the building immediately before the loss, we will pay the greater of the following amounts, but not more than the limit of liability under this policy that applies to the building: (1) The actual cash value of that part of the building damaged; or (2) That proportion of the cost to repair or replace, after application of any deductible and without deduction for depreciation, that part of the building damaged, which the total amount of insurance in this policy on the damaged building bears to 80% of the replacement cost of the building. c. To determine the amount of insurance required to equal 80% of the full replacement cost of the building immediately before the loss, do not include the value of: (1) Excavations, footings, foundations, piers, or any other structures or devices that support all or part of the building, which are below the undersurface of the lowest basement floor; (2) Those supports described in (1) above which are below the surface of the ground inside the foundation walls, if there is no basement; and (3) Underground flues, pipes, wiring and drains. d. We will pay no more than the actual cash value of the damage until actual repair or replacement is complete. Once actual repair or replacement is complete, we will settle the loss as noted in 2.a. and b. above. However, if the cost to repair or replace the damage is both: (1) Less than 5% of the amount of insurance in this policy on the building; and (2) Less than $2,500; we will settle the loss as noted in 2.a. and b. above whether or not actual repair or replacement is complete. e. You may disregard the replacement cost loss settlement provisions and make claim under this policy for loss to buildings on an actual cash value basis. You may then make claim for any additional liability according to the provisions of this Condition C. Loss Settlement, provided you notify us of your intent to do so within 180 days after the date of loss.
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Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
The facts and circumstances giving rise to the Insurer’s violation as the Insured understands them at this time:
Saday Hernandez Asen (hereinafter the “Insured”) purchased a property insurance policy, policy number SIC3063401 (hereinafter the “Subject Policy”) from Slide Insurance Company (hereinafter “Slide”) which, at all times material hereto, provided property insurance for the property located at 8711 North Pawnee Avenue, Tampa, FL 33617 (hereinafter the “Subject Property”).
On or about September 26, 2024, Hurricane Helene, a covered cause of loss, caused direct physical loss and resultant ensuing damages to the Subject Property.
The Insured immediately notified Slide of the loss. Slide assigned claim number 202409005402 to the loss (hereinafter the “Claim”).
On or about September 28, 2024, the Insured hired Public Adjuster Luis Guzman of Universal Claims Adjusters, who came out to the property, performed an inspection, and took photographs of the damages.
That same day, Slide sent their Field Adjuster, Donald Davis out to the subject property to perform an inspection.
Additionally, Slide sent a mitigation company to the subject property to install a tarp onto the roof to prevent further damages.
On or about October 14, 2024, the Public Adjuster prepared an estimate for repairs totaling $47,921.06 and forwarded same to Slide.
On or about October 16, 2024, the Slide issued its Coverage Determination Letter and stated that “Our investigation revealed wind damage on the front, right, rear slopes of the roof, and gutters damaged, water damage to master bedroom ceiling.” Attached to the coverage letter was an inaccurate and incomplete estimate for repairs totaling $8,522.76, prepared by Field Adjuster Donald Davis, that failed to include repairs to the wind-damaged slopes of the roof and failed to include any line-items for repairs to the water-damaged interior of the subject property. Slide issued a payment to the Insured in the amount of $3,093.34 after subtracting the policy deductible of $4,720.00 and recoverable depreciation in the amount of $709.42.
As a result of the inaccurate and incomplete estimate and insufficient, unilaterally determined payment from Slide, the Insured retained legal counsel.
Subsequently, the Insured’s Public Adjuster prepared a revised estimate for repairs, totaling $131,075.64, to include repairs to the wind-damaged slopes of the roof, which were determined to be covered in Slide’s coverage letter, dated October 16, 2024.
On or about January 28, 2025, counsel emailed Slide’s desk adjuster, Sonya Harris, a copy of the Public Adjuster’s revised estimate for repairs. Additionally, counsel requested a phone call with Ms. Harris to discuss the claim. To date, counsel never received any response from Ms. Harris regarding the request for a phone call or the receipt of the revised estimate.
On or about February 12, 2025, the Insured’s attorney filed a Notice of Intent to Initiate Litigation and attached the Public Adjuster’s revised estimate. In response to the Notice, Slide alleged that the Notice was not in compliance with Florida Statutes §§ 627.70152 and 627.70131 because the Public Adjuster’s revised estimate for repairs constituted a supplemental claim to which Slide had not had an opportunity to investigate and render a coverage determination. It is important to note, the only area which was revised in the Public Adjuster’s estimate was the main roof, which has already been fully and completely inspected and investigated by Slide and to which Slide has already rendered a coverage determination where it found covered wind damages to the front, right, and rear slopes. Therefore, Slide’s contention that the Notice of Intent is not compliant with Florida Law is totally and completely unfounded and inaccurate.
It is clear that the carrier is not treating the Insured with good faith claims conduct; failing to pay a claim clearly owed; not adjusting the claim and evaluating the loss properly, promptly and fairly to provide full and prompt indemnity to the Insured; failing to implement proper standards for the adjustment and investigation of claims and placing the company’s interests before the Insured’s interests; not training, supervising or managing adjusters properly so that prompt and full payments are made; refusing to pay the full amount owed to the Insured despite the fact that the damages are covered under the policy; looking for ways to delay full recovery or any recovery to the insured; and refusing to provide coverage for the Insured’s loss in a timely manner.
To cure the above-mentioned immoral, deceptive, unlawful and collectively defined general business practice of Bad Faith claims handling practices that are knowingly, willfully, wantonly and/or with a reckless disregard for the Complainant’s interests being implemented, Slide must perform as follows within 60 days of receiving this Notice.
1. Take corrective action in association with the Bad Faith claims handling practices by way of rectifying same and thereafter duly adjusting, investigating and issuing payment for all benefits owed to the Complainant for indemnity in the amount of $131,075.64;
2. Take corrective action in association with the Bad Faith claims handling practices by way of rectifying same and thereafter duly adjusting, investigating and issuing payment for all benefits owed to the Complainant;
3. To the extent verified after duly performing under the policy pursuant to cited authorities and considerations, issuing any and all payments owed to the Complaint for interest on benefits that were untimely paid;
4. After exercising good faith efforts to resolve the claim, issuing payment to the Complainant for any attorney’s fees and/or costs that it cannot dispute are due and owing;
5. As it relates to any claims/benefits that may remain in dispute or undetermined, fairly, honestly, specifically, meaningfully and substantively disclosing to the Complainant’s counsel the basis therefor and the means to promptly reach resolution; and/or
6. Otherwise fulfilling any and all obligations under the policy that it knows, or should know, remain to be performed.
Please do not hesitate to contact the undersigned at (954) 529-0695 if you have any questions or concerns.
Sincerely,
Aaron D. Melamed, Esq.
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The submitter hereby states that this notice is given in order to perfect the rights of the
person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.
Before submitting a Notice using this system, please verify that all text has been entered
correctly and completely. Once the Notice has been submitted, the text cannot be changed
or deleted.
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DFS-10-363
Rev. 10/14/2008
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